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Berwick Resigns as CMS Chief

November 23, 2011
by Mark Hagland
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Berwick’s Principal Deputy, Marilyn Tavenner, to be nominated

On Nov. 23, the White House announced that Donald M. Berwick, M.D., had resigned as administrator of the federal Centers for Medicare and Medicaid Services (CMS), effective Dec. 2. By law, Berwick’s appointment, made as a recess appointment on July 7, 2010, would have expired on Dec. 31.

Praising Berwick for “outstanding work,” White House deputy press secretary Jamie Smith criticized Congressional Republicans for their entrenched opposition to President Obama’s nomination of the physician and industry leader, an opposition that caused the President to use the recess-appointment option to install Berwick as CMS administrator in the summer of 2010. In order to continue Berwick’s tenure into 2012, Obama would have had to resubmit his nomination to the U.S. Senate, where conservative Republicans remained opposed.

Donald Berwick, M.D.

Instead, Berwick will be replaced by his principal deputy, Marilyn Tavenner, formerly Virginia’s top healthcare official. The White House said Obama will submit Tavenner’s nomination to the Senate. According to an Associated Press report Nov. 23, “Tavenner has been at Medicare since early last year, earning a reputation as a problem solver with years of real-world experience and an extensive network of industry contacts. A nurse by training,” the report noted, “the 60-year-old Tavenner worked her way up to the senior executive ranks of a major hospital chain. She ran Virginia’s health department under former Democratic Gov. Tim Kaine.”

Tavenner has been principal deputy administrator of CMS since February 2010, and was acting administrator from February to July 2010. During nearly 35 years in healthcare, Tavenner has practiced as a nurse (she has a B.S. in nursing and an M.A. in health administration), a hospital CEO, and a senior executive in various positions for the Hospital Corporation of America (HCA).
Marilyn Tavenner

According to a Nov. 23 report on National Public Radio by Mary Agnes Carey and Phil Galewitz, Tavenner told a gathering of the National Association of Medicaid Directors last month that “The only way to stabilize costs without cutting benefits or provider fees is to improve care to those with the highest healthcare costs.” The NPR report quoted Len Nichols, director of George Mason University’s Center for Health Policy Research and Ethics,” as saying that he expected Tavenner to bring the same policy approach to the job that Berwick had. “She brings continuity in terms of implementing the mission,” Nichols told NPR.

During his tenure, Berwick oversaw the drafting and implementation of various elements of federal healthcare reform, which arose out of the passage of the Affordable Care Act, signed into law by President Obama in March 2010.

In an email to his staff, Berwick said that he leaves with “bittersweet emotions.” According to the AP report, Berwick wrote that “Our work has been challenging, and the journey is not complete, but we are now well on our way to achieving a whole new level of security and quality for healthcare in America, helping not just the millions of Americans affected directly by our programs, but truly healthcare as a whole in our nation.”

Healthcare Informatics will continue to update readers on emerging developments in this area.

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